Active NPI
Lynda A Spann, PH.D.
- Marriage & Family Therapist
- Pueblo, CO
National Provider Identifier
1548371701
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 366
- Practice address
- 417 W 13TH St
Pueblo, CO 81003-2703 - Phone
- (719) 544-0877
- Fax
- (719) 544-2033
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 366 | CO | Primary |
Addresses
Primary practice location
417 W 13TH St
Pueblo, CO 81003-2703
Mailing address
417 W 13TH St
Pueblo, CO 81003-2703
Phone (719) 544-0877
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 096184 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 366 | CO | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548371701",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 W 13TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032703",
"telephone_number": "719-544-0877",
"fax_number": "719-544-2033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 W 13TH ST",
"city": "PUEBLO",
"state": "CO",
"postal_code": "810032703",
"telephone_number": "719-544-0877",
"fax_number": "719-544-2033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPANN",
"first_name": "LYNDA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CO",
"license": "366",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "096184",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
- Spanish Peaks Mental Health Center
- Spanish Peaks Mental Health Center
- Spanish Peaks New Alternatives, Inc. (Health Solutions Medical Center)
- Spanish Peaks New Alternatives, Inc. (Spanish Peaks New Alternatives Inc. SUD)
- Spanish Peaks New Alternatives, Inc. (Perry Hall PC)
- Sparks of Light Psychotherapy, PLLC
- Sparks Residential and Support Services, Inc
- Melissa R. Sparks, PTA
- Penny Sue Spearing, MA, LPC
- Specialized Inpatient Medical Services, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.